Karavelioğlu Yusuf, Karapınar Hekim, Özkurt Sultan, Sarıkaya Savas, Küçükdurmaz Zekeriya, Arısoy Arif, Kurt Recep, Yılmaz Ahmet, Kaya Mehmet G
Department of Cardiology, Çorum Training and Research Hospital, Hitit University, Çorum, Turkey.
Echocardiography. 2014 Apr;31(4):449-55. doi: 10.1111/echo.12422. Epub 2013 Oct 24.
There are no definite data about the atrial electromechanical coupling times (AEMCT) in patients with end stage renal failure (ESRF). The aim of this study was to investigate the AEMCT in ESRF patients without hypertension (HT) and diabetes mellitus.
The study population consisted of 47 normotensive, nondiabetic ESRF patients and 41 healthy age/gender-matched control subjects. The time intervals from the onset of P-wave on the surface electrocardiogram to the beginning of late diastolic A-wave (PA) were obtained from the lateral mitral annulus (PA-lateral, maximum AEMCT), septal annulus (PA-septal), and tricuspid lateral annulus (PA-tricuspid). Time intervals were corrected according to the heart rate. The difference between PA-septal and PA-tricuspid (right AEMCT), PA-lateral and PA-septal (left AEMCT), and PA-lateral and PA-tricuspid (inter AEMCT) were calculated. Corrected time intervals were used for calculations.
Groups were similar for age (52 ± 12.3 vs. 49.9 ± 6 years, P > 0.05) and gender. Maximum (61 ± 20 vs. 47 ± 13 ms; P < 0.001) AEMCT was significantly higher in the patients compared with the control group, but septal and tricuspid EMCT were not different (P > 0.05). Both inter-atrial (37 ± 21 vs. 24 ± 16 ms, P = 0.002) and left atrial (25 ± 18 vs. 12 ± 9 ms; P < 0.001) EMCT were significantly higher in patients when compared with the controls but intra-right atrial EMCT was not different.
Atrial conduction parameters such as maximal EMCT, left atrial, and inter-atrial EMCTs were prolonged in ESRF patients. This prolongation is seen in ESRF patients even in the absence of factors that affect atrial coupling, such as HT.
关于终末期肾衰竭（ESRF）患者的心房机电耦联时间（AEMCT），尚无确切数据。本研究旨在调查无高血压（HT）和糖尿病的ESRF患者的AEMCT。
研究人群包括47例血压正常、无糖尿病的ESRF患者和41例年龄/性别匹配的健康对照者。从体表心电图P波起始到舒张晚期A波开始的时间间隔，分别从二尖瓣环外侧（PA-外侧，最大AEMCT）、间隔环（PA-间隔）和三尖瓣外侧环（PA-三尖瓣）获取。时间间隔根据心率进行校正。计算PA-间隔与PA-三尖瓣之间的差值（右AEMCT）、PA-外侧与PA-间隔之间的差值（左AEMCT）以及PA-外侧与PA-三尖瓣之间的差值（心房间AEMCT）。计算时使用校正后的时间间隔。
两组在年龄（52±12.3岁对49.9±6岁，P>0.05）和性别方面相似。与对照组相比，患者的最大AEMCT（61±20对47±13毫秒；P<0.001）显著更高，但间隔和三尖瓣的EMCT无差异（P>0.05）。与对照组相比，患者的心房间EMCT（37±21对24±16毫秒，P=0.002）和左心房EMCT（25±18对12±9毫秒；P<0.001）均显著更高，但右心室内EMCT无差异。
ESRF患者的心房传导参数，如最大EMCT、左心房和心房间EMCT均延长。即使在没有影响心房耦联的因素（如HT）的情况下，ESRF患者也会出现这种延长。
